Atrial Fibrillation
Also known as AF, AFib, Irregular heartbeat
This article is general health information for the selected condition. It is not a diagnosis and does not replace clinical judgement. If you have questions or need treatment advice, please consult a qualified healthcare professional.
What is atrial fibrillation?
Atrial fibrillation is the most common sustained abnormal heart rhythm. The upper chambers of the heart quiver instead of contracting cleanly, producing an irregular pulse. The central concern is not the palpitations but the stroke risk, because blood pooling in the atrium can form clots. Anticoagulation decisions are therefore the most important part of management.
Causes
- Age related changes in atrial tissue
- High blood pressure
- Heart valve disease and heart failure
- Overactive thyroid
- Alcohol excess and obstructive sleep apnoea
- Acute illness such as sepsis or pneumonia
Symptoms
- Palpitations or a fluttering sensation in the chest
- Irregular pulse
- Shortness of breath
- Fatigue and reduced exercise capacity
- Dizziness or light headedness
- Chest discomfort
- No symptoms at all in a substantial proportion of people
Risk factors
- Increasing age
- Hypertension
- Obesity and obstructive sleep apnoea
- Diabetes
- Excess alcohol intake
- Existing heart or thyroid disease
Diagnosis
- Pulse check and ECG showing absent P waves with irregular rhythm
- Ambulatory monitoring for intermittent episodes
- Echocardiogram to assess structure and valves
- Thyroid function and electrolyte testing
- Stroke risk scoring, commonly with CHA2DS2 VASc
Treatment
- Anticoagulation to reduce stroke risk when indicated
- Rate control with beta blockers or calcium channel blockers
- Rhythm control with antiarrhythmic medicines
- Electrical cardioversion
- Catheter ablation for selected patients
- Treating alcohol excess, sleep apnoea and obesity
Self care
- Take anticoagulation every day without missing doses
- Learn to check your own pulse
- Limit alcohol, which is a strong and often underestimated trigger
- Treat sleep apnoea if present
- Reduce caffeine if it reliably triggers episodes
- Keep to a healthy weight and stay active
- Carry an anticoagulant alert card
When to see a doctor
Book an appointment if:
- Episodes becoming more frequent or longer
- New breathlessness or reduced exercise tolerance
- Ankle swelling
- Unusual bruising or bleeding on anticoagulation
- Before any surgery or dental procedure
- Persistent fatigue despite rate control
Some symptoms need emergency care rather than an appointment. See the warning signs listed above.
Prevention
- Treat high blood pressure
- Reduce alcohol intake
- Lose weight if overweight, which reduces episode burden
- Diagnose and treat obstructive sleep apnoea
- Manage diabetes and thyroid disease
- Stay physically active without extreme endurance overload
Outlook
Atrial fibrillation is usually a long term condition, but the outlook with treatment is good. Anticoagulation reduces stroke risk by roughly two thirds, and rate or rhythm control manages symptoms. Ablation can eliminate episodes for many, particularly early paroxysmal disease. Addressing alcohol, weight and sleep apnoea often reduces how often it returns.
Common questions
Why is atrial fibrillation dangerous if I feel fine?
Stroke risk is driven by clot formation in the quivering atrium, not by how strong the palpitations feel. Many people with no symptoms still need anticoagulation, which is why the rhythm is treated seriously even when it is well tolerated.
Is aspirin enough to prevent stroke in atrial fibrillation?
No. Aspirin is substantially less effective than oral anticoagulants for this purpose and is no longer recommended as an alternative for stroke prevention in atrial fibrillation.
Can atrial fibrillation be cured?
Catheter ablation can eliminate episodes for many people, particularly with paroxysmal disease, but recurrence is possible and anticoagulation decisions are based on overall stroke risk rather than on rhythm alone.
References
Important: Dard AI is not a medical device and does not diagnose, treat, or replace clinician judgement. This article is general information only. Always consult a qualified healthcare professional about diagnosis and treatment, and seek emergency care for severe or rapidly worsening symptoms.